Scoliosis: Should My Child Have Surgery?

Scoliosis: Should My Child Have Surgery?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Scoliosis: Should My Child Have Surgery?

1

Get theFacts

2

CompareOptions

3

YourFeelings

4

YourDecision

5

QuizYourself

6

Your Summary

Get the facts

Your options

Schedule surgery to treat scoliosis.

Don't schedule surgery yet. Schedule regular checkups to see if the curve is getting worse. Children may wear a brace to keep the curve from getting worse.

Key points to remember

Mild curves are usually checked by the doctor every 4 to 6 months until the bones stop growing, to be sure the curves are not getting worse.

Moderate curves may need to be braced until the bones stop growing, to keep the curves from getting worse.

Severe curves or moderate curves that are getting worse may need surgery.

The main type of surgery is a spinal fusion. The curved part of the backbone is straightened with rods, wires, hooks, or screws. Then small pieces of bone are put over the spine. These pieces of bone will grow together, or fuse, with the spine, holding it in the proper position.

Instrumentation without fusion is another type of surgery to straighten the spine. The doctor attaches metal rods to the spine without fusing the bones together. This is only done in younger children who are still growing. It's used when doctors don't want to fuse bones together because it would stop growth in that area of the spine. The child usually has to wear a brace full-time after having this surgery.

A moderate to severe spinal curve that is getting worse and is not fixed with surgery is likely to keep getting worse.

As scoliosis gets worse, the bones of the spine move toward the inside of the curve. If it happens in the upper part of the spine, the ribs may crowd together on one side and spread apart on the other side. The curve may force the spinal bones closer together. The spinal bones on the outer edge of the curve may also get thick.

In severe curves, the ribs that are pulled out of position may reduce the amount of air the lungs can hold. They also may cause the heart to work harder to pump blood through the compressed lung tissue. Over time, this may lead to breathing problems and heart failure.

Scoliosis that is present at birth or that occurs in infants may be worse over time than a spine that curves later in life. If an infant or young child with a severe spinal curve does not have surgery, it is likely that the curve will get worse. This is because the curve gets worse as the child grows.

If the curve gets bad enough, it could affect your child's breathing and heart.

Your child could have pain and trouble doing daily activities.

Personal stories about surgery for scoliosis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

My daughter was diagnosed with a mild to moderate spinal curve when she was 16 years old. Tests showed that she was almost done growing, and her doctor said it was likely that the curve would not get worse. We were relieved because we didn't want her to have surgery, but of course we didn't want her to have problems with her back as she got older.

Mother of Linda, age 17

When my daughter was in the sixth grade, I noticed that her clothes seemed to hang unevenly. We looked at her back and saw that her shoulders were not even. Her doctor examined her and took X-rays of her spine. To our shock and surprise, she had a large spinal curve. Because of her age, the fact that she was just starting her teenage growth spurt, and the size of her spinal curve, it was likely that her spinal curve would get worse. We decided that surgery would provide the best chance for stopping the curve from growing and for stabilizing her spine.

Father of Marta, age 14

My daughter's doctor says her scoliosis curve is moderate and surgery might keep it from getting worse. But surgery scares me, and the scoliosis isn't bothering her. I'd rather take her to regular checkups for a while and see if the curve gets worse.

Mother of Sarah, age 12

My son and I had a long talk about surgery. He really misses playing sports. And it's important to him to be in the best shape possible when he's older. So it's important to me too. We're choosing surgery.

Father of Henri, age 13

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to schedule surgery for scoliosis

Reasons not to schedule surgery for scoliosis

I want to get rid of my child's back pain.

Exercise and over-the-counter medicine work well to control my child's pain.

More important

Equally important

More important

A curved spine keeps my child from doing a lot of the activities that he or she likes.

My child is still able to do the things that he or she likes to do.

More important

Equally important

More important

I worry that my child's spine will get worse as he or she grows.

I would rather wait and see if my child's spine gets worse as he or she grows.

More important

Equally important

More important

My child can take a time off from school or work to recover from the surgery.

My child can't take a lot of time off right now to recover from the surgery.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Surgery

Waiting

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.1, If your child has any amount of spinal curve, should you schedule surgery?

YesSorry, that's not right. Surgery is recommended only for severe spinal curve. Most spinal curves are not bad enough to need surgery.

NoYou're right. Surgery is recommended only for severe spinal curve. Most spinal curves are not bad enough to need surgery.

I'm not sureIt may help to go back and read "Get the Facts." Surgery is recommended only for severe spinal curve. Most spinal curves are not bad enough to need surgery.

2.2, Can a brace help keep a child's spinal curve from getting worse?

YesThat's right. A brace can keep a child's spinal curve from getting worse.

NoSorry, that's not right. A brace can keep a child's spinal curve from getting worse.

I'm not sureIt may help to go back and read "Get the Facts." A brace can keep a child's spinal curve from getting worse.

3.3, Should you consider surgery if your child's moderate curve is getting worse?

YesThat's right. Doctors usually recommend surgery if a moderate spinal curve is getting worse, or for a severe curve.

NoSorry, that's not right. Doctors usually recommend surgery if a moderate spinal curve is getting worse, or for a severe curve.

I'm not sureIt may help to go back and read "Get the Facts." Doctors usually recommend surgery if a moderate spinal curve is getting worse, or for a severe curve.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Scoliosis: Should My Child Have Surgery?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Schedule surgery to treat scoliosis.

Don't schedule surgery yet. Schedule regular checkups to see if the curve is getting worse. Children may wear a brace to keep the curve from getting worse.

Key points to remember

Mild curves are usually checked by the doctor every 4 to 6 months until the bones stop growing, to be sure the curves are not getting worse.

Moderate curves may need to be braced until the bones stop growing, to keep the curves from getting worse.

Severe curves or moderate curves that are getting worse may need surgery.

FAQs

What is scoliosis?

Scoliosis is an abnormal curve in the spine . The spine curves from side to side in an "S" or "C" shape rather than being straight. The spine also may be twisted.

What kind of surgery can fix a spinal curve?

The main type of surgery is a spinal fusion. The curved part of the backbone is straightened with rods, wires, hooks, or screws. Then small pieces of bone are put over the spine. These pieces of bone will grow together, or fuse, with the spine, holding it in the proper position.

Instrumentation without fusion is another type of surgery to straighten the spine. The doctor attaches metal rods to the spine without fusing the bones together. This is only done in younger children who are still growing. It's used when doctors don't want to fuse bones together because it would stop growth in that area of the spine. The child usually has to wear a brace full-time after having this surgery.

How can surgery help?

Surgery usually can improve the curve and keep it from getting worse. Surgery may also help decrease pain and allow your child to do more daily activities.

Each child's scoliosis is different. Talk to your child's doctor about whether surgery can help.

What are the risks of surgery?

Risks of surgery to fix a spinal curve include:

Problems that can happen with back surgery, such as nerve damage, lung problems, or spinal cord damage.

No more growth in the fused area of a child's spine. This could mean that a child may be slightly less tall than he or she would be without fusion.

Problems that can happen in any surgery, such as blood clots or infection or problems from anesthesia. The risk of these problems is higher in older adults than in younger people.

Talk to your doctor about your child's chances of having problems from surgery.

Other problems include lost time at school or at work for recovery and the possible need to wear a body cast or brace for a few months after surgery.

What are the risks of not having surgery?

A moderate to severe spinal curve that is getting worse and is not fixed with surgery is likely to keep getting worse.

As scoliosis gets worse, the bones of the spine move toward the inside of the curve. If it happens in the upper part of the spine, the ribs may crowd together on one side and spread apart on the other side. The curve may force the spinal bones closer together. The spinal bones on the outer edge of the curve may also get thick.

In severe curves, the ribs that are pulled out of position may reduce the amount of air the lungs can hold. They also may cause the heart to work harder to pump blood through the compressed lung tissue. Over time, this may lead to breathing problems and heart failure.

Scoliosis that is present at birth or that occurs in infants may be worse over time than a spine that curves later in life. If an infant or young child with a severe spinal curve does not have surgery, it is likely that the curve will get worse. This is because the curve gets worse as the child grows.

Why might your doctor recommend surgery to fix scoliosis?

Your doctor might suggest surgery for your child if:

Your child has a moderate to severe curve, and it's getting worse.

Your child has pain or trouble doing daily activities.

Bracing cannot be used or does not work.

2. Compare your options

Schedule surgery

Don't schedule surgery

What is usually involved?

Your child will likely stay in the hospital for several days after surgery.

Your child will have to spend a few weeks at home. Your child can go back to school in 3 or 4 weeks.

For 6 to 12 months, your child can't do anything that could jar the spine—such as roller skating or skiing.

Your child may need to wear a body cast or brace for a few months after surgery.

Your child gets checkups every 4 to 6 months to see if the curve is getting worse.

Any surgery can cause problems such as bleeding, blood clots, and infection. Anesthesia also can cause problems.

Back surgery has a risk of nerve damage, lung problems, or spinal cord damage.

In a child, spinal fusion will stop growth in the area of the spine that is fused. This could mean that a child may be slightly less tall than he or she would be without fusion.

The spinal curve could get worse.

If the curve gets bad enough, it could affect your child's breathing and heart.

Your child could have pain and trouble doing daily activities.

Personal stories

Personal stories about surgery for scoliosis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"My daughter was diagnosed with a mild to moderate spinal curve when she was 16 years old. Tests showed that she was almost done growing, and her doctor said it was likely that the curve would not get worse. We were relieved because we didn't want her to have surgery, but of course we didn't want her to have problems with her back as she got older."

— Mother of Linda, age 17

"When my daughter was in the sixth grade, I noticed that her clothes seemed to hang unevenly. We looked at her back and saw that her shoulders were not even. Her doctor examined her and took X-rays of her spine. To our shock and surprise, she had a large spinal curve. Because of her age, the fact that she was just starting her teenage growth spurt, and the size of her spinal curve, it was likely that her spinal curve would get worse. We decided that surgery would provide the best chance for stopping the curve from growing and for stabilizing her spine."

— Father of Marta, age 14

"My daughter's doctor says her scoliosis curve is moderate and surgery might keep it from getting worse. But surgery scares me, and the scoliosis isn't bothering her. I'd rather take her to regular checkups for a while and see if the curve gets worse."

— Mother of Sarah, age 12

"My son and I had a long talk about surgery. He really misses playing sports. And it's important to him to be in the best shape possible when he's older. So it's important to me too. We're choosing surgery."

— Father of Henri, age 13

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to schedule surgery for scoliosis

Reasons not to schedule surgery for scoliosis

I want to get rid of my child's back pain.

Exercise and over-the-counter medicine work well to control my child's pain.

More important

Equally important

More important

A curved spine keeps my child from doing a lot of the activities that he or she likes.

My child is still able to do the things that he or she likes to do.

More important

Equally important

More important

I worry that my child's spine will get worse as he or she grows.

I would rather wait and see if my child's spine gets worse as he or she grows.

More important

Equally important

More important

My child can take a time off from school or work to recover from the surgery.

My child can't take a lot of time off right now to recover from the surgery.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Surgery

Waiting

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1. If your child has any amount of spinal curve, should you schedule surgery?

Yes

No

I'm not sure

You're right. Surgery is recommended only for severe spinal curve. Most spinal curves are not bad enough to need surgery.

2. Can a brace help keep a child's spinal curve from getting worse?

Yes

No

I'm not sure

That's right. A brace can keep a child's spinal curve from getting worse.

3. Should you consider surgery if your child's moderate curve is getting worse?

Yes

No

I'm not sure

That's right. Doctors usually recommend surgery if a moderate spinal curve is getting worse, or for a severe curve.

Decide what's next

1. Do you understand the options available to you?

Yes

No

2. Are you clear about which benefits and side effects matter most to you?

Yes

No

3. Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

Use the following space to list questions, concerns, and next steps.

Credits

By

Healthwise Staff

Primary Medical Reviewer

John Pope MD - Pediatrics

Primary Medical Reviewer

Adam Husney MD - Family Medicine

Primary Medical Reviewer

Kathleen Romito MD - Family Medicine

Primary Medical Reviewer

Robert B. Keller MD - Orthopedics

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This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.